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The days of expensive PET scans and invasive spinal taps for Alzheimer’s diagnosis are now behind us.
In a groundbreaking policy shift, CMS has finalized a $130 reimbursement rate for the newly FDA-approved blood tests that detect Alzheimer’s biomarkers.
Why this matters to every healthcare provider:
• These blood tests cost 80-90% less than traditional diagnostics
• They deliver results with 97.9% negative predictive value
• They’re FDA-approved for adults 55+ showing cognitive symptoms
• Primary care physicians can now rule out Alzheimer’s without specialist referrals
But the real impact goes beyond diagnostics.
This decision directly connects to the new wave of disease-modifying Alzheimer’s treatments. Earlier diagnosis means earlier treatment, potentially slowing cognitive decline by 30-60% in eligible patients.
For FQHCs and community health centers, this opens a pathway to offer high-quality diagnostic services that were previously available only at specialized centers.
For hospital executives, this represents a new revenue opportunity while dramatically improving the patient journey. The days of 18-month waits for memory clinic appointments may soon be over.
For imaging centers, this requires strategic planning. While PET scans remain the gold standard for amyloid confirmation, blood tests will reshape patient flow and referral patterns.
The bipartisan Alzheimer’s Screening and Prevention (ASAP) Act introduced this month aims to further streamline coverage, ensuring these tests reach Medicare beneficiaries without unnecessary delays.
As healthcare leaders, we now have a powerful new tool in addressing one of our most challenging conditions. The question isn’t whether to implement these tests, but how quickly and effectively you can integrate them into your care pathways.
What’s your organization’s plan for implementing these breakthrough diagnostics?
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Author:
CEO/Co-Founder @ Oatmeal Health | AI Lung Cancer Screening | Almost Became a Doctor | Engineer | Follow to Share What I’ve Learned Along the Way
I help patients get the care they need earlier, preventing late-stage cancer.
That’s been the throughline across three companies and almost 20 years in healthcare. At ReferralMD, we fixed broken referral networks so patients didn’t fall through the cracks. At Oatmeal Health, it’s lung cancer: building the diagnostic and screening infrastructure so the 85% of cases caught too late get caught early instead.
Today as CEO of Oatmeal Health, I lead a team embedding AI into radiology workflows to turn routine lung CT scans into reimbursable cancer risk assessments. We partner with FQHCs to reach underserved communities, and with health systems and payers to make early detection economically sustainable. Think HeartFlow or Cleerly, but for lungs.
Between companies, I advised at Techstars and Plug and Play, mentoring founders building in digital health. That experience shaped how I think about what separates companies that ship from companies that stall: distribution, reimbursement, and clinical trust, not just technology.
I’m a CancerX alumnus, a 3x healthcare founder, and someone who believes the biggest problems in cancer aren’t scientific. They’re operational.
We’re hiring mission-driven builders at Oatmeal Health. If you want to work on something that matters, reach out.
When I’m not working, I’m traveling, mentoring, and keeping up with one very energetic husky. 🐾
Substack – The Oatmeal Bite:
Millions of patients get less care because of who they are, where they live, or how they look. I’m fighting to change that. CEO @OatmealHealth, a startup built for the underserved. The Oatmeal Bite: intel for clinicians, investors, and advocates.
Jonathan Govette
CEO of Oatmeal Health
Substack:
https://oatmealhealthjonathangovette.substack.com/
